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November 19, 2003

School-Based Interventions for Children Exposed to Violence

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(19):2541. doi:10.1001/jama.290.19.2541-a

In Reply: We agree with Dr Rappaport that involvement of teachers and school administrators is an important component of the entire program. As we have discussed in greater detail elsewhere,1,2 we involved teachers and school administrators from the early stages of program development and evaluation design. We paid extensive attention to ensuring the program's cultural competency, including the use of bilingual, bicultural therapists, and the pretesting of program and evaluation materials in this population. We believe that these efforts have been an important part of both the program's effectiveness and its acceptability to schools, parents, and students. Because the school-level interventions (increased teacher support and education) happened for all students, they cannot be responsible for the differences between the early intervention and delayed intervention groups. However, these interventions could have contributed to the improvement in the delayed intervention group in the period prior to receiving our intervention.